PDF Version
To: Providers using the Digital Upload Form
Re: Changes to Digital Upload of Supporting
Documentation
Effective April 15, 2024, Administrative
Review (Dental ONLY) form type will be added to the dropdown on the Digital
Upload form located on the Provider Secure Web Portal.
The Provider Secure Web
Portal allows users to digitally upload additional supporting documentation for
the following form types: Administrative Review (Dental ONLY), Consent, Third Party Liability Claims, Prior
Authorization, Prior Authorization Reconsideration.
After initial submission of
one of the above form types, providers may submit additional supporting
documentation using the Digital Upload
form which can be accessed within the Alabama Medicaid Interactive Web Portal.:
https://www.medicaid.alabamaservices.org/ALPortal/.
- On the Trade Files tab, select Forms.
- In the Form Name dropdown list, select DIG - Digital Upload and click Search.
To complete the form, the
following information is required:
- Record ID (from initial form submission)
- Form Type
- PA or ICN or CA Number or ACN (from initial form submission)
Attachments being submitted
must be in PDF format.
Once submitted, the
supporting documentation will be added to the original form submission.
Note:
Providers with questions
concerning the upload of supporting documentation should contact their Provider
Representative. Contact information may be found at the following link:
http://medicaid.alabama.gov/content/10.0_Contact/10.3_Provider_Contacts/10.3.5_Provider_Reps.aspx.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2024
American Medical Association and © 2024 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.